Over time, technology has become a strong ally in the field of medicine.
The use of intracoronary insertion devices or stents continues to be the basis in the management of myocardial infarctions. Photo: Shutterstock.
Over time, technology has become a strong ally in the field of medicine. Machines, computers, and other robotic equipment have revolutionized science and health. They not only serve to simplify surgical procedures, but also help to improve and prolong the lives of patients. Some of these great advances are the so-called medical devices that have taken an important role in the management of heart conditions such as myocardial infarctions.
medical devices for the heart
According to the World Health Organization (WHO), medical devices are “essential for safe and effective prevention, diagnosis, treatment and rehabilitation of disease and illness”. The WHO points out that a medical device can be “any instrument, apparatus, implement, machine, implant, reagent for in vitro use, software, material or other similar or related article”. The Food and Drug Administration (FDA) is the body in charge of regulating the safety and efficacy of these devices before they can be marketed and used in a medical office or hospital.
In the case of heart diseases, there are devices that are used to treat some conditions and that can be placed inside or outside the patient’s body, depending on the condition and its severity. One of the most innovative is the stent or intracoronary prosthetic device that is used for acute myocardial infarctions, commonly known as heart attack.
“A myocardial infarction is when an artery in the heart becomes clogged and that heart muscle loses its oxygen supply and death of that part of the heart occurs. For this, there are multiple medications that can be used as therapy for the management of myocardial infarction. But what has revolutionized the management of heart attacks are stents, which are an intracoronary device that helps stabilize or uncover the area where the heart attack occurred, restoring the oxygen supply”
explained interventional cardiologist Héctor Martínez González.
What is the goal of the stents?
According to Dr. Martínez González, the stent -an invasive procedure inserted through specialized catheters in the groin or arm area- is used to
“Release the narrowing that may occur in the arteries of the heart associated with a heart attack and can also be used to manage angina or chest pain”. “And why do people get chest pain? It can be for two things: because they already have a narrowing in the heart artery, which has caused the patient to have chest pain or they develop an acute myocardial infarction. Because one thing is chest pain, which can be a symptom that develops little by little, versus myocardial infarction, which can cause sudden chest pain.”
added the director of the Department of Cardiology and the Catheterization Laboratory of the Hospital Mayagüez Medical Center.
The use of this device in Puerto Rico
On the use of intracoronary insertion devices or stents,the cardiologist stated that:
“In Puerto Rico there are few hospitals that carry out this procedure. In the metro area there are approximately 4 or 5 hospitals that do it, in the southern area there are two hospitals and in the western area we are the only hospital that does this procedure”.
In the event that the patient goes to a hospital where this type of device is not available, powerful drugs known as thrombolytics are used to unclog the artery associated with a clot.
“These drugs are of secondary use when we do not have the first alternative of a mechanical procedure to open the artery such as the stent. When I put the stent I am unclogging the artery, while when I give the medication, the medication is the one that is trying to block different phases within the pharmacodynamics of the process to unclog the artery”
the specialist specified.
Likewise, Martínez González pointed out that any patient with an acute myocardial infarction might be considered for the insertion of the stent why “the most important thing is that he has an acute myocardial infarction where we suspect that the patient has an occluded heart artery where there is a dramatic benefit to triggering one of these stents and releasing that obstruction. Very few patients are not candidates for this procedure. The oldest patient that I have operated on is 97 years old”.
The cardiologist also emphasized the safety and effectiveness of medical devices such as stentsused in more than 90% of acute myocardial infarction cases in the United States.
“That the patient knows that we have them available in Puerto Rico, that it is the best alternative and that he knows how to recognize the symptoms quickly, because the faster he gets to the hospital, the faster he can be given the therapy and help the heart attack not get bigger. ”, accurate.
Other devices for heart disease
As for other devices to treat cardiac conditions such as defibrillators and pacemakers, the cardiologist indicated that they can be used but in another way because they do not work for acute heart attacks.
“These are devices for when the heart is already weak or the scientific word is cardiomyopathy, which means that an area or different areas of the heart have become very weak and these devices such as pacemakers or defibrillators are an option at that stage. In the acute stage where we use the meshes it is an emergency stage where we need to save the patient’s life immediately. The defibrillator helps a lot to reduce long-term mortality, while the mesh -by uncovering the artery- we are saving the patient’s life immediately”
the doctor specified.
The use of aspirin
Regarding the traditional medicines that for years have been used to manage heart attacks such as aspirin, the cardiologist stated that although it is still important for the management of these cases “Today aspirin has taken a secondary role because we have better fast-acting drugs that can work to alleviate or try to stop the symptoms of a heart attack.”
Important to recognize the symptoms
Finally, the doctor stressed the importance of patients learning to recognize the symptoms of myocardial infarction so that they can go to an emergency room as quickly as possible.
“The most important symptoms are pain or burning in the chest (which is the traditional one), respiratory distress, dizziness or profuse sweating. However, there are patients such as diabetics and women who have atypical symptoms that can not only be chest pain, but also pain in the neck, jaw, back and a feeling of fullness in the stomach or epigastric pain, which can also be confused”
said the incoming governor of the Puerto Rico chapter of the American College of Cardiology.
